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See a sample rate comparisonCPT 22865 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Remval Of Total Disc Arthroplst (Artifici Disc) Anterio Approac, Removal Of Total Disc Arthroplasty (Artificial Disc) Anterior Approac
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None 59 - Distinct Procedural Service 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22865 |
| Medicaid Fee Schedule | View Medicaid rates for 22865 |
National average reimbursement for CPT 22865 by major payers:
$2,763.23
$2,863.25
$3,078.04
$3,473.17
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CPT 22865
5 of 25 sample ratesHigher to lower in this preview
Carolina Regional Surgery Center. Ltd
Carolina Regional Surgery Center Ltd
$8,200.00Published rateAdvanced Surgery Center Of Tampa, LLC
$6,087.00Published rateVirginia Ent Surgery Center Inc
Virginia Ear, Nose & Throat Associates, P.C.
$3,070.00Published rateFlorida Eye Institute Surgicenter LLC
$1,813.00Published rateWinter Haven Sebring Fl Ophthalmology Asc LLC, Eye Surgery & Laser Center
$905.00Published rate
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See a sample payer proposalCPT 22865 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22865 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 22865 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 22857-CPT | High | Tot Disc Arthrp 1ntrspc Lmbr, Total Disc Arthroplasty Artificial Disc Anterior Approach Including Discectomy To Prepare Interspace Other Than For Decompression Single Interspace Lumbar |
| 22860-CPT | Moderate | Tot Disc Arthrp 2ntrspc Lmbr, Total Disc Arthroplasty Artificial Disc Anterior Approach Including Discectomy To Prepare Interspace Other Than For Decompression Second Interspace Lumbar List Separately In Addition To Code For Primary Procedure |
| 22861-CPT | High | Once Per Dos Revision Including Replacement Of Total Disc Arthroplasty, Anterior Approach, Single-Medicaid:Rn Review>9/15/2015.Commercial Rn Review=9/15/2015-3/31/2022 |
| 22865-CPT | High | Remval Of Total Disc Arthroplst (Artifici Disc) Anterio Approac, Removal Of Total Disc Arthroplasty (Artificial Disc) Anterior Approac |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22865. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22865 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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